EXAM 1 - Continued sets

Two years

-kicks large ball -turns pages (2 or 3 at a time) -imitates housework -recognizes familiar picture-knows if it is upside down -asks for items by name -uses 2 or 3 words together such as "more juice"

Fifteen Months

-may walk without support -stacks 3 blocks -vocalizes-voice up and down sounds like conversation -may say 4 or 5 words -some self feeding

diversity

(n.) difference, variety; a condition of having many different types of forms

Age range for ericksons 2nd stage

1-3y autonomy vs shame and doubt

Middle Age Age Range

25-65 years

schoolager

5 years through 12 years

Describe specific ways the nurse can develop and improve in Greater cultural knowledge

Acculturation, or firsthand contact between different group would greatly expand the nurses knowledge, as well as time and experience. Each patient is an individual with different life experiences and culture should be viewed as more of a spectrum.

Young adults have achieved full physical and sexual maturation and have left behind the problems of ______________. Young childhood Formal education Adolescence Family dysfunction

Adolescence

Rule of decent

Arbitrarily assigns a race to a person on the basis of a societal dictate that associates social identity with ancestry

An major assessment for toddlers

Are they walking?

Which statement is true for attachment in the newborn?

Attachment is the I interaction between parents and child

Which sleep pattern would the nurse recognize as normal in preschoolers?

Average 12 hours a night

Ethnocentrism

Belief that one's culture is superior to that of another

industry vs inferiority

Erikson's Theory of Psychosocial School Age

Respect E

Explanatory model

Which statement defines the term "family resiliency"?

Family can cope with stressors

Birth

Grasping, rooting, tonic neck,

Young Adult Health Assessment Questions

Intimate Partner Violence Mental Health Conditions Anxiety Disorders & Depression

Which plant, if ingested by a preschool-age client, would necessitate further action by the nurse?

Lily

When caring for elderly patients, healthcare professionals should be aware of __________ because these individuals often take so many different medications. Polypharmacy Addiction to prescription meds Confusion Over-medicating

Polypharmacy

Which gross motor milestone is exhibited by 3-year-olds?

Repeatedly catching a ball

When putting an infant down to sleep, place him or her on

The back. Side sleeping isn't recommended. However, if the infant in dependently rolls onto the abdomen, don't roll him or her onto the back again; instead, allow the infant to stay in that position.

Which behavior would be exhibited in a 2-year-old child after the death of a family member?

The child exhibits changes in eating and sleeping patterns

Which rationale supports the use of family therapy when a child has a terminal illness?

The entire family is involved because what happens with one member affects them all

Ethnicity

The person's identification with or membership in a particular racial, national, or cultural group and observation of the group's customs, beliefs, and language. It is based on cultural similarities and differences within a society or nation. Similarities occur with members of the same group; differences occur between members of the group and others.

Assimilation

The process by which individuals from one cultural group merge with, or blend into a second group

A client is dying. Hesitatingly, his wife says to the nurse, "I'd like to tell him how much I love him, but I don't want to upset him." Which is the correct response by the nurse?

You should share your feeling with him while you still can

Developmental level

individual's stage of development

Ongoing SIDS are needed.

research and surveillance

Developmental tasks

unique set of skills and competencies that needs to be mastered at each developmental stage in order for the individual to cope with the environment

Developmental Tasks

unique set of skills and competencies that needs to be mastered at each developmental stage in order for the individual to cope with the environment

intimate partner violence (IPV)

violence is physical, sexual, emotional, or psychological abuse, threatened or actual, by a current or ex-spouse, current or ex-boyfriend or girlfriend, cohabiting partner, or date.

Young Adult Physical Characteristics

•The body has finished fully developing •nutritional and activity needs move away from promoting growth to maintaining a healthy body. •skeletal system will continue to grow until age 30. •gastrointestinal system will begin to decrease secretions

Middle Age Physical Characteristics

•wrinkles begin to appear •hair thins •waist thickens •Muscle tissue (muscle mass) and muscle strength tend to decrease •Bones become less dense •hearing high-pitched sounds becomes more difficult. •The skin becomes thinner, less elastic, drier •nerve cells in the brain decreases with aging. •heart and blood vessels become stiffer

Young toddlers understand _______ and respond to boundaries set by their caregivers. Multi-step instructions 'No' Emotions Written instructions

'No'

Four basic elements of culture are recognized: Culture is

(1) learned, (2) symbolic, (3) shared, and (4) integrated.

a family consists of

(1) parents and their children; (2) those related by blood, such as ancestors and descendants; or, in a less restricted definition, (3) any group living together as if they were related by blood. A family is who they say they are.

Family consists of

(1) parents and their children; (2) those related by blood, such as ancestors and descendants; or, in a less restricted definition, (3) any group living together as if they were related by blood.

Define the concept of culture / diversity

*a pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language or live in a defined geographical region. *These dimensions guide such areas as social relationships; expression of thoughts, emotions, and morality; religious beliefs and rituals; and use of technology.

What are some interventions to help someone who has stereotypes

*visiting ethnic neighborhoods *sampling different foods; *ethnic grocery stores, or herb shops; *walking into botánicas, *speaking with someone from another culture; *learning a foreign language *speaking with a hospital translator; *attending a service at a mosque or synagogue; *going to a gay pride march *Puerto Rican day parade; *reading journals that represent different groups; *reading a novel about someone growing up in another culture.

Four Months

-Good head control. -Rolls from side to side. -Takes object, such as rattle, held near hand. -May begin reaching. -Follows moving object when held in sitting position. -Laughs aloud. -Enjoys play.

Two Months

-Holds head erect, bobbing when supported in sitting position. -Follows moving person with eyes. -Imitates or responds to smiling person with occasional smile. -Vocalizes.

Four Years

-Hops in place. -Throws ball over head, catches ball bounced to him. -Copies circle. -Points to 6 basic colors. -Knows own sex, age, last name. -Begins to play with other children. -Uses sentences. -Washes hands.

Two Years

-Kicks large ball. -Turns pages (2-3 at a time) -Imitates housework. -Recognizes familiar picture- Knows if it is upside down. -Asks for items by name. -Uses 2-3 words together such as "More Juice"

Three Months

-Lifts head and chest when lying on stomach. -Vigorous body movements. -Head control is improving. -Recognizes bottle or breast. -Coos -Chuckles

Fifteen Months

-May walk without support. -Stacks 3 blocks. -Vocalizes- voice up and down sounds, like conversation. -May say 4-5 words. -Some self feeding.

Nine Months

-Sits alone- changes position without falling. -Plays with two objects at the same time. -Says ma ma, ba ba.

Infant- Physical Characteristics

1 month- Infant can lift the head when placed in a prone position. 3 month- Smiles at the sound of caregiver's voice. 7 month- Rolls from front to back and from back to front, Sits with support and then without it. 12 months- Gets to sitting position without assistance, Crawls forward on belly, using arms and legs to push By 6 months baby should have doubled his weight and triple his weight by his first birthday

Infant- Health Assessment Questions (pag 246 yoost has more)

1 to 3 Months • Does your baby smile at you? • Does your baby seem to try to talk to you when you talk to her? • Does your baby hold an object if you put it in her hand? 4 to 6 Months • Does your baby roll from back to side? • Does your baby put toys in his mouth? • Does your baby say "da-da" or "ma-ma"? 7 to 9 Months • Can your baby sit up either supported or unsupported? • Can your baby focus on an object for longer periods of time than in previous months? • Does your baby get upset when you leave the room? • Is your baby crawling or trying to stand? 10 to 12 Months • Is your child trying to walk? If so, with or without support? • What words does your child say? • Does your child play games like peek-a-boo?

list of questions one would ask using the RESPECT model for a client

1. What do you call the problem? 2. What do you think has caused the problem? 3. Why do you think it started when it did? 4. What do you think the sickness does? How does it work? 5. How severe is the sickness? Will it have a long or short course? 6. What kind of treatment do you think you should receive? 7. What are the chief problems the sickness has caused? 8. What do you fear most about the sickness?

Adolescent Age Range

11-18 years

toddler

12 months through 36 months

adolescent

12 years through 18 years

Age range for ericksons 5th stage

12-18y identity vs role confusion

Toddlers- Age Range

18 months-3 years

Young Adult Age Range

18-25 years

Age range for ericksons 6th stage

18-34 intimacy vs isolation

young adult

18-35 years

Tweens typically grow ________ per year. 4-5 inches 3-4 inches 1-2 inches 2-3 inches

2-3 inches

Describe EBP interventions for patients across the lifespan with alterations in cognition

24 hour supervision /assistance with care are needed. If patient is cared for at home, information on day care and respite care is provided. Simple calm environments help to optimize function in dementia patients. Use of door locks if pt wanders. Referral to home health agencies if needed

Infant- Age Range

28 Days to 18 months

Infant- Cognitive Characteristics

3 MONTHS- Babbles, Follows a moving object with eyes, Smiles socially 7 MONTHS-Responds to own name, Uses voice to express pleasure, Finds partially hidden objects 12 MONTHS-Says "da-da" and "ma-ma", Tries to imitate words

Pre-School Age Range

3-6 years

Age range for ericksons 3rd stage

3-6y initiative vs guilt

Age range for ericksons 7th stage

35-55 Generativity vs stagnation

middle adult

35-65 years

preschooler

36 months through 5 years

For the first 6 months, infants tend to gain __________ every week. 4 to 8 ounces 2 to 3 ounces Nothing One pound

4 to 8 ounces

Age range for ericksons 8th stage

55+ integrity vs despair

The first signs of teeth should arrive between __________ months. 6 to 12 4 to 6 12 to 18 None of the above

6 to 12

School Age Age Range

6-11 years

Age range for ericksons 4th stage

6-12y industry vas inferiority

Which of these clients seen at a health fair will be most at risk for hypertension?

62 yr old African American male

Older Adult Age Range

65 years-death

young-old

65-75 years

For a neonate, normal blood pressure should be about _______. 120/75 100/60 50/20 65/40

65/40

Which description of family-centered care is correct?

A collaborative plan of care is developed to achieve optimal health.

Which education would the nurse provide the parent of a preschool-age child about how preschoolers view death?

A form of sleep

Cultural openness

A lifelong stance that promotes cultural self-awareness and continuing development of transcultural skills.

Acculturation

A mechanism of cultural change achieved through the exchange of cultural features resulting from firsthand contact between groups.

Ethnicity

A person's identification within a group and observation of the groups customs, beliefs and language

What is family?

A primary unit of socialization, basic structural unit within a community.

Race

A socially constructed concept that tends to group people by common descent, heredity, or physical characteristics. It has been a practice in the United States to use the rule of descent to categorize people by race. Race is thought by many to have a biological basis. However, this assumption is not true.

Which information is true regarding cognitive changes of a teenager?

A teenager considers an infinite variety of causes and solutions.

A 50-year-old client has difficulty communicating because of expressive aphasia after a cerebrovascular accident (CVA, also known as a "brain attack"). When the nurse inquired about the client's feelings, the spouse responded. Which communication strategy would the nurse use to address this behavior?

Acknowledge spouse but wait for client response

Immediate memory

Aka attention span allow memory of very small amounts of information for a short time

Working memory

Allows a small amount of information to be actively maintained and manipulated for a short period of time

Describe specific ways the nurse can develop and improve in Greater cultural skill

Along with knowledge, skill will also be improved with time and experience. The nurse should be practicing culturally congruent care, by creating safe and meaningful ways to promote health within their cultural boundaries.

Risk factors for individuals or populations across lifespan related to sensory perception

Alteration is patients sensory perception can cause problems with ability to perform adls. Issues with memory, ability identify sensations, vision, hearing, smelling and tasting perceptions decrease. Football and other hard contact sports put the younger population at risk for Brian injuries

What are the risk factors for individuals or populations across lifespan for cognition

Alterations in cognition can make it difficult for people to communicate and carry out activities of daily living on their own. It causes confusion, disorientation, and decreased motor skills. These people tend to have difficulty understanding hcp causing aggression or emotional. They may be forgetful and have issues with the senses

Over 5 million people in the U.S. are living with _________. Women are especially at risk, with 1 in 6 being diagnosed in her 60s. Osteoporosis Sexual dysfunction Decreased visual acuity Alzheimer's disease

Alzheimer's disease

older adult

An adult age 65

developmental level

An individual's current state of physical, emotional, and intellectual development

A teenage girl faces a long hospitalization after surgery. How can the girl's continued development be fostered? a. Encourage her to write her feelings in a journal. b. Divert her attention by playing video games. c. Encourage her to work on craft projects. d. Make sure her parents are constantly by her side.

Answer: a Teenagers are capable of abstract thought and often find it helpful to verbalize their feelings either by talking or by journaling. Diverting her attention by playing video games and encouraging her to work on craft projects are measures that may be used to help her pass the time but are not methods of fostering teen development. A teen usually does not wish parents to be at his or her side constantly and may want some private time away from them.

How is the toddler's need for autonomy best met? a. The parents' consistently meeting the child's needs b. Encouraging imaginative play c. Allowing the child limited choices d. Promoting experimentation to determine cause and effect

Answer: c The toddler's need for autonomy can best be supported by allowing the child choices within limits. Parents consistently meet the child's needs during the infant period. In later developmental stages, imaginative play is encouraged, and experimentation is promoted to determine cause and effect.

The nurse is caring for a group of older adults. Which patient(s) in this group is/are exhibiting normal signs of aging? (Select all that apply.) a. The patient with knee pain and wrinkles around the eyes b. The patient who needs reading glasses and states that the food tastes bland c. The patient who is confused and does not know the current year d. The patient who states that constipation is an increasing problem e. The patient who is showing signs of depression and hopelessness

Answers: a, b, d Normal aging includes signs of decline in many organ systems. Knee pain, skin wrinkles, need for reading glasses, decline in taste buds, and constipation all can occur with aging. Normal aging does not include dementia or depression, even though these can both be diagnosed in the older adult population.

Reticular activating system

Area of Brain that controls alertness and attention

To help prevent SIDS, parents should be told to place infants on their ______ to sleep. Stomach Side Back Arms

Back

The current standards require placing a neonate in a car seat facing __________. Forward Backward A parent None of the above

Backward

How best can a nurse evaluate goal attainment for a patient with a culturally diverse background?

Base decisions on feedback from the patient and the nurse's professional judgment.

RESPECT model therapeutic alliance and trust

Bearing in mind the meaning of these concepts in the nursing relationship enhances communication and assessment skills between patient and nurse and creates a _____________________________.

Age range for 1st Erickson stage

Birth to 18mo trust vs mistrust

The nurse is assessing a child who is accompanied by a parent and a stepbrother. Which kind of a family does this child belong to?

Blended

What family dynamics place a family as risk for dysfunction?

Blended families /role change, Low income/socioeconomic status Age of family members Family classification Family Hx Illness Culture Norms Trauma Conflict Relocation Substance abuse Addiction Domestic violence

During middle adulthood, a decrease in _________________ can cause a decrease in height. Stature Bone density and bone mass Muscle tone All of the above

Bone density and bone mass

Define memory

Broadly refers to the retention and recall of past experiences and learning. It's not a single unified mental ability but rather a series of different neural subsystems, each of which has a unique location in the brain

Infant- Psychosocial Characteristics

By 6 months, the infant recognizes familiar faces, and he responds to their emotions. the infant enjoys playing with his parents and looking at himself in the mirror. by age 7 to 8 months,will experience stranger anxiety separation anxiety, which peaks between 9 and 10 months. begin to develop a sense of security if his caregivers meet his needs constantly and with predictability. trust vs mistrust

Older Adult Health Assessment Questions

COPD • Have you had any respiratory problems in the past such as asthma, pneumonia, or frequent respiratory infections? • Have you ever had tuberculosis? • Do you smoke? • Do you experience shortness of breath with walking or lying down? • Have you ever lived or worked in an area with heavy pollution from traffic, factories, or mining?

Which question is the most therapeutic to ask the parents of a 3-year-old child who has just died?

Can I be of any help with traditional practices that are important to you?"

Health assessment questions the rn should ask related to sensory perception

Can you feel the difference between hot and cold? Have you ever had a sore in your leg or foot that wouldn't heal? Do you have any pain, numbness, tingling in hands legs or feet?are you able to smell different foods? Can you taste salty, sweet and sour? Have you noticed changed in your hearing? Do you every lose your balance or feel like room is spinning? When was your last eye exam? Can you see objects to your left and right? And blurriness? Nurse may want to have pt draw a picture of clock

developmental milestones

Characteristics and behaviors considered normal for children in specific age groups.

What is the best method for the nurse to ensure that a Croatian patient's nutritional needs are met during hospitalization?

Check with the patient on admission to determine dietary limitations and preferences.

Which behavior is seen in children at the undifferentiated stage of spiritual development, as propounded by Fowler?

Children have no concept of right or wrong to guide their behaviors.

Which initial purpose would value clarification serve?

Client becomes aware of personal values

List EBP intervention the nurse would provide to pt with sensory alterations

Comprehensive health assessment identifies present health risks, future health risks, and health promoting activities. Eye muscles and cranial nerves tested. Internal eye exam. Safety in the home and hospital. Knowledge of pt past and current medical conditions is essential, closely monitor pt at high risk for metabolic syndrome. Pt at high stress levels can be similar to sensory overload. Thorough sleep history to rule out sleep deprivation

Respect C

Concerns

According to Freud, which must occur before an individual is able to have a mature adult sexual relationship?

Conflict resolution

A Spanish-speaking client is being cared for by English-speaking nursing staff. Which communication technique would be correct for the nurse to use when discussing health care decisions with the client?

Contact hospital interpreter

From ages 5-9 ___________ improves and there is more interest in team sports such as soccer and little league. Mental focus Social skill Respect for adults Coordination

Coordination

The nurse leader is teaching the staff that the health care provider strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?

Cultural competence

In what ways are they dependent upon one another? Shared beliefs values and behaviors

Culture is an attribute of essentially all members of a group, not just individuals. People who grow up in a particular culture often have shared values, beliefs, ideals, and expectations. These shared attributes are absorbed and transmitted through generations of teaching and sharing ideas, traditions, and rituals

A child who has newly arrived from Latin America attends a nursery school where everyone speaks English. The mother is concerned the child is no longer outgoing and has become passive in the class. Which is the probable reason for the child's behavior?

Culture shock

Tactile

Damage to sensory nerve fibers in arms and legs leads to peripheral neuropathy.

Sensory deprivation

Decreased stimulation from environment

The terrible twos are a phase when toddlers not only disobey their parents, but openly _______ them. Defend Disappoint Distract Defy

Defy

The nurse understands which medication may cause gynecological malignancies in females?

Diethylstilbestrol may cause gynecological malignancies such as endometrial, ovarian, and cervical cancers.

if your giving a school-age child an shot and they are scared, what do you do?

Direct answers, simple term teaching

The pre-teen is prone to _________ both at home and with friends, and if they occur, he may either rebel or withdraw into solitary behaviors. Secrets Isolation Disputes Bullying

Disputes

Which factor increases an adolescent's risk for injury in the community?

Distracted driving

Three major assessments for older adults

Do they have good Hygiene, self-care and Grooming, can they go to the bathroom? Can they stay focused and hold a conversation? Are they able to stay sitting or standing and remained steady?

Preschool children remain __________, yet they want to please their family and friends. Egocentric Irrational Independent None of the above

Egocentric

Middle age is also a time for mid-life crisis, which may be exacerbated by ______________. Parenthood Teenage children Empty nest syndrome Early memory loss

Empty nest syndrome

identify vs role confusion

Erikson's Theory of Psychosocial Adolescent

trust vs mistrust

Erikson's Theory of Psychosocial Infant

generativity vs self-absorption & stagnation

Erikson's Theory of Psychosocial Middle Age

integrity vs despair

Erikson's Theory of Psychosocial Older Adult

initiative vs guilt

Erikson's Theory of Psychosocial Pre-schooler

autonomy vs shame and doubt

Erikson's Theory of Psychosocial Toddlers

intimacy vs isolation

Erikson's Theory of Psychosocial Young Adult

Which would the nurse consider to be the center of decision-making when providing client care?

Ethics

Which statement best serves as a guide for nurses seeking to learn more about ethnicity?

Ethnicity is based on cultural similarities and differences in a society.

There are several concepts that link to culture. Such as:

Ethnocentrism since it's a certain belief and perceived notion that one's culture is superior than another. Assimilation is a transmitted behavioral pattern were individuals leave their cultural identity in order to blend into a new one. Socialization is socially transmitted behavior(s) that is geared toward individuals acquiring certain characteristics. Family is the basic unit for developing customs and values

changes to family dynamics

Expanding family (birth or adoption of an infant; blended family) • Caregiver role for family member • Change in socioeconomic status of family • Chronic illness of family member • Marriage, divorce/remarriage • Traumatic injury of family member • Disability of family member • Aging of family members • End-of-life care • Death of family member

If a painful procedure such as a blood draw must be performed on a preschooler, the nurse should ____________ and then give the child a coping mechanism. Explain it honestly Not tell the child ahead of time Only explain it to the parent None of the above

Explain it honestly

Which would the nurse consider before confronting the problem of obesity with individual children?

Familial and cultural influences are deciding factors in eating habits.

The nursing student is learning about the realms of family life. Which component would be included while learning about integrity processes?

Family rituals

Etic

Focus on outsider's world and especially on professional views.

How are they similar? Shared beliefs, values and behaviors

Four basic elements of culture are recognized: Culture is (1) learned, (2) symbolic, (3) shared, and (4) integrated. culture may be viewed as a complex whole in which all parts are related. Culture has a family and group component, but it is not transmitted biologically. The values, beliefs, and traditions of a group must be learned by each person within the family and social community. Culture includes social constructs such as knowledge, beliefs, art, morals, and customs, as well as law. One shared element found in all cultures is an understanding of gender roles, the roles that a particular culture assigns to men and women. Although the world is changing, certain values and beliefs regarding gender roles remain unchanged in many cultures

Generativity versus Stagnation

Generativity can be accomplished by successfully rearing one's own children or by engaging in other activities that promote creativity and productivity. If the person fails to grow during this phase, the result may be stagnation with self-absorption (egocentric behavior) and self-indulgence.

Four potential nursing diagnoses for individuals with alterations in sensory perception

Glaucoma- condition of eye causes increased vascular pressure which puts pressure on optic nerve leading to loss of vision Meniere disease cause tinnitus and vertigo Peripheral neuropathy- damage to sensory nerve fibers in arms and legs causes decreased tactility Anosmia- complete loss of snelk

At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group?

Good boy nice girl

Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action?

Grow in conjunction with axillary hair follicles

In young adulthood, nutritional and activity needs have shifted away from _________ and toward ______________ a healthy body. Development; achieving Growth; maintaining Advancement; earning None of the above

Growth; maintaining

Which would the nurse anticipate when assessing a preschool-age child, according to Erikson's developmental stages?

Having highly imaginative thoughts

Several hours after delivery, a new mother expresses ambivalence regarding her infant. How will the nurse promote bonding between this mother and her newborn?

Having mother feed infant

Which is the primary focus of nursing care in the "family as context" approach?

Health and development of individual

Adolescent Health Assessment Questions

Health assessment questions should be directed to the adolescent, rather tn to parents. • What are your favorite activities? • What do you eat on a normal day? • Tell me about school. • Do you have friends? • Do you get along with your parents? siblings? • Do you have a boyfriend or girlfriend? • Are you having sex? If so, what type? How many partners? • Have you ever used drugs? tobacco products? • Do you drink alcohol? • Do you ever feel sad?

Health risks associated with ericksons 5th stage

Identity vs role confusion- Exploring and integrating roles, emerge from stage with sense of individuality, Physical and sexual changes from puberty, increased nutritional needs,adequate sleep, long for privacy, independence, isolation, body image, peer influence, and communication with family. Some risk factors include unintentional injuries, violence, sexual behaviors, pregnancy, std, substance abuse, unhealthy dietary behaviors, inadequate physical activity, suicide. Approach non threatening and no judgement, *ensure confidentiality*

A client who is in the advanced stages of illness asks the nurse to contact pastoral services for support. According to the Macmillan model, which is the correct nursing intervention in this situation?

Immediately involve pastoral services while caring for the client

Initiative versus Guilt

In this stage, children's maturing physical and verbal abilities encourage them to expand their world. Families can best encourage this sense of initiative by allowing children to run, jump, play, and throw. Children at this time are exploring what kind of people they may become. Parents who limit their children's attempts at initiative cultivate a sense of guilt in children during this stage that may persist into later life as well.

Health risks associated with ericksons 3rd stage

Initiative vs guilt- had your child had frequent infections? Are they potty trained? Typical diet? Do they play with others? Can they talk in sentences? Can they write their name? Can they make believe? What activities do they like?

Describe physical assessment the rn would complete for sensory assessment

Inspect external eye, visual acuity, eye movement, ophthalmic examination, pupillary response, evaluate hearing, inspect internal and external ears, inspect tongue and oral cavity, inspect nose and check for latency of nasal airway, test taste and smell. Robert rest for balance, test of hot, cold, sharp and dull. Monofilament testing

A child wants to be on time for a family dinner. According to Kohlberg's theory, which stage of development is the child experiencing?

Instrumental relativist orientation

Health risks associated with ericksons 8th stage

Integrity vs despair- Pleased with accomplishments or hung up on past failures.Review life events, accept finality of death, adjust to physiological changes such as decreased sense, loss of mobility, physical deterioration, and increased health complications. Emotionally trying to find a purpose, experiencing empty nest, loss of spouse, decreased cognition including decreases memory and reflexes. allergies? Medications? Home life? ADL? Family support? Diet/exercise? LOC/ mental status? Advanced directive/ DNR? Can they sit, stand, and balance on edge of bed? Self care? Grooming? Attention span?

The nurse is assessing a middle-aged client whose children have left home in search of work. The client is trying to adjust to these family changes. Which family life-cycle stage is the client going through?

Launching children's and moving on

When a school ager is in a healthcare setting, his biggest fear is _________. Losing control The unknown Needles Strangers

Losing control

Describe specific ways the nurse can develop and improve in Greater cultural desire

Many people become nurses because they care about others and want to help them. Caring for patients is individual and includes meeting their needs with which their culture greatly affects. Nurses should strive to be transcultural to provide all of their patients with the best possible care

Which statements reflect the practice of transcultural nursing?

May be considered a general and specialty practice area Challenges traditional ethnocentric nursing practice Aims to identify individual patient care preferences

Young adulthood is the time when __________ peaks with sharp reasoning skills, creative imaginations, rapid information recall, and proficiency in communication. Mental ability Social skill Emotional adjustment Physical ability

Mental ability

One of the most common issues facing ______________ is feeling that they are sandwiched between meeting the needs of their children and partner as well as those of their aging parents. Middle aged adults Young adults Adults age 65 and over None of the above

Middle aged adults

Describe specific ways the nurse can develop and improve in Greater cultural awareness

Nurses can develop and improve on cultural awareness by avoiding stereotypes, prejudice, and discrimination, as well as being cautious with generalizations. The nurse must be free of ethnocentrism and understand how diverse our society is. Also, by practicing cultural sensitivity, the nurse is recognizing differences among cultures.

List two examples of nursing diagnosis related to cognitive impairments

Nursing diagnoses refers to identifying the problems that are present that could be caused by disease or disorder, the nurse is only identifying problems. Nurse would diagnose inability to comprehend simple addition, impaired or inability to draw clock, impaired language communication

A chronically ill, older client lives with their daughter. The client reports the daughter, who has three small children, seems run-down, coughs a lot, and sleeps all the time. Which statement supports the need for the nurse to pursue the daughter's condition as a potential case

Older adults with chronic illness are more susceptible to tuberculosis.

Which stage of the development would the nurse document for an infant when using Freud's theory of psychosocial development?

Oral

Describe lab tests the rn would review when assessing cognitive changes

Order a CBC to rule out infections. ABG's to see if hypoxia. Rental panel to check electrolytes and urinalysis to ensure patient does not have UTI.

The nurse working in a Catholic hospital discourages clients from using contraceptives per hospital policy. Which category of ethics is the nurse following?

Organizational ethics

Sensory overload

Over abundance of stimuli causes the brain to cease making sense of incoming stimuli

The practice of separating parents from their newborn immediately after birth and limiting their time with the infant during the first few days after delivery contradicts studies related to which?

Parent child attachment

Which relationship is the most important to the formation of personality?

Parent child relationships

The parents of a critically ill child constantly blame each other for their child's illness. Which parental response suggests that the nurse's intervention has been successful?

Parents make appointment with family counselor

List outcomes for individuals with alterations in sensory perception

Patient will respond appropriately to questions of time and place within 48 hours, pt will communicate basic needs through photos within 1 week, pt will interact with other nursing homes residents during planned activities

The young toddler enjoys riding and pulling toys. He can climb, run awkwardly, and by 18 months, begin to _____________. Play a sport Balance on a beam Pedal a tricycle Do somersaults

Pedal a tricycle

Describe how culture influences the three categories:

People who grow up in a particular culture often have shared values, beliefs, ideals, and expectations. These shared attributes are absorbed and transmitted through generations of teaching and sharing ideas, traditions. culture is the "common denominator" that makes the actions of a person intelligible to other group members. One shared element found in all cultures is an understanding of gender roles, the roles that a particular culture assigns to men and women. Although the world is changing, certain values and beliefs regarding gender roles remain unchanged in many cultures.

Which key factor assists the nurse in assessing how a client will cope with the body image change after an above-the-knee amputation?

Personal perception of change

Toddlers- Physical Characteristics

Physical growth slows but the continues to develop rapidly in many ways. •should have eight teeth. •body shape beginning to change as "baby fat" slowly disappear because increased physical activity. •Visual acuity improves, and binocular vision is developed. •can tolerate a variety of foods Motor and Sensory Characteristics •By 2 1/2 they are able to jump on two feet •enjoys riding and pulling toys. •begin to pedal a tricycle •He can climb & run awkwardly •has learned to walk up and down stairs holding on to an adult's hand •can drink from a cup and eat with a spoon with some help. •help dress and undress himself. learns new skills by demonstration and copying rather than by instruction.

The nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. Which action would the nurse manager take to address this problem?

Plan a workshop that offers opportunities to learn about the cultures the nurses might encounter while at work.

A major milestone at age 3 is that sphincter control has matured and the child can be ready for _____________. Potty training Bathroom breaks Swim lessons None of the above

Potty training

Respect P

Power

Identify factors associated with an increased incidence of abuse within a family.

Pregnancy, drug abuse, sexual orientation

According to Piaget's theory, which period describes a child's stage of egocentrism?

Preoperational

Which stage of Piaget's theory of cognitive development would the nurse observe in a preschooler?

Preoperational

an preschool child is getting a shot what would you do to help that child from being scared?

Preschool children are big into imaginary play. for example you can distract them with puppets or toys.

Prejudice

Process of devaluing an entire group because of assumed behavior, values, or attributes. (Yoost 382) A preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes. (Yoost 22) There is no room for prejudice in professional nursing practice. Unchecked prejudicial thoughts and actions may lead to discrimination and unequal care of individual patients. (Yoost 382)

In providing effective nursing care to clients from different cultural backgrounds, which strategy would the nurse follow?

Providing care that fits the clients cultural beliefs

Maturation

Qualitative change associated with aging that enables cells to function at higher or optimal level

Differentiation

Qualitative change from simplex to complex by which intially formed cells and structures becomes specialized

Maturation

Qualities change associated with aging that enables cells to function at a higher or optimal level

Define growth

Quantitative changes that can be measured and compared with norms e.g. height and weight.

Growth

Quantitive change in which an increase in cell number and size results in overall body size or weight or any of its parts

4 weeks to 6 months

Raise head, roll over, support weight

The normal heart rate for a neonate should be: Rapid, from 150 to 180 beats per minute Rapid, from 120 to 160 beats per minute Moderate, from 80 to 100 beats per minute Slow, from 40 to 60 beats per minute

Rapid, from 120 to 160 beats per minute

Lifestyle changes for older adults commonly include income ________ and a return to _________ due to the loss of a spouse or partner. Stability; celibacy Increase; marriage Reduction; single life None of the above

Reduction; single life

Executive function

Refers to higher thinking processes that allow for flexibility, adaptability, and goal directedness. Executive function determines contents of consciousness, supervised voluntary activity, and is future oriented

Declarative memory

Refers to the ability to consciously learn and recall information. It provides long term storage for large amounts of info

Declarative semantic memory

Refers to the memory of knowledge, words and facts

Procedural memory

Refers to the retention and retrieval of motor skills. Requires extensive training and provides for long term storage of a moderate amount of info

Tweens can express their feelings, likes, and dislikes, and discuss issues that are _________ to them. New Relevant Offensive Unfamiliar

Relevant

Older adults want ________ and control of their lives, and do not want to be treated as children. Respect Detailed guidance Hands-on help Deference

Respect

Respect R

Respect

Which concept of death would the nurse expect a 4-year-old child to have?

Reversible separation

The preschoolers behavior can be modified by ____________, so the child needs a clear and consistent set of boundaries. Parental interventions Rational arguments Rewards and punishments Persuasion

Rewards and punishments

Rituals

Rituals are formal, stylized, and repetitive actions performed in special places at special times. These actions convey information about participants and are used to inform others about the beliefs and traditions of a culture. Examples include praying, dancing, fasting, singing, meditating, and reading sacred texts. Rituals can sustain and provide support for patients during a time of illness or suffering. In caring for patients, nurses need to be aware of their own beliefs and feelings regarding certain rituals, as well as understand how these rituals may affect their patients and families.

Health concerns and risks for birth to 18 mo

SIDS, colic, abuse, shaken baby syndrome Safety- empty cribs, small objects put up, baby sleeps on back, parent/ visitor hygiene, don't microwave formula or breast milk

Olfaction

Sense of smell

Between the ages of 7 to 10 months, infants commonly experience ____________. Irrational fears Separation anxiety Temper tantrums None of the above

Separation anxiety

Development

Sequence of physical, psychosocial, and cognitive development changes that take place over the human lifespan

The nurse is developing a plan of care for the client who has activity intolerance. Which intervention would the nurse do to obtain the desired client outcomes?

Set priorities and outcomes using the client's and family input

Toddlers- Psychosocial Characteristics

Show a wide range of emotions, including affection, joy as well as frustration and anger. Young toddlers are social, Hand toys over to initiate play Often picky eaters Will say no even when they really want to say yes. like routine.

The home health care nurse visits a client who lives with her two grandchildren. Which term would the nurse use to define this family form?

Skip generation family

Teens, because of their activities and growth, need a lot of ________. Sleep Encouragement Distraction Vitamins

Sleep

As infants become toddlers, their growth rate ____________. Stays the same Increases Varies Slows

Slows

Which stage of Kohlberg's theory of moral development is associated with a person following a law even if it is discriminatory to a racial group?

Social contract orientation

Social structure

Social structure determines how people interact with one another (Yoost p. 381). · Social structure is 1 of 3 components that most work together to keep a culture strong.

Respect S

Sociocultural context

Developmental age

Stages of development determined by general age range

Normal neonate reflexes include grasping, rooting, and ____________. Singing Falling Startling Head bobbing

Startling

Stereotype

Stereotype is a set of fixed ideas, often unfavorable, about members of a group. The difference in stereotype and generalization lies not in the content but in the usage of the information.

Parents should be advised that toddlers like to imitate adult behaviors, so it is critical that tools, matches, and other harmful objects be _________________. Eliminated from the home Stored out of reach or locked up Demonstrated for proper use None of the above

Stored out of reach or locked up

superstructure

Superstructure or worldview, provides a belief system that helps people identify themselves, their society, and the world around them.

symbols

Symbols are signs, sounds, clothing, tools, customs, beliefs, rituals, and other items that represent meaningful concepts. Language is the most important symbolic aspect of culture because words are used to represent objects and ideas. Nonverbal symbols are images, such as flags of countries, that represent shared ideas or beliefs. Another example of a symbol is a single red cross and red crescent side by side on trucks and armbands for the international federation of red cross and red crescent societies.

Which medication treatment may have been given during gestation to a mother whose baby was born with shortened limbs?

Thalidomide

What is the RESPECT model?

The RESPECT model of cultural assessment is based on a series of eight questions developed by Kleinman A blueprint to develop skills needed to become culturally competent. RESPECT is an acronym: Respect, Explanatory model, Sociocultural context, Power, Empathy, Concerns and fears, and Therapeutic alliance/trust.

reproduction

The addition of children, whether by birth, adoption, or blending of families, increases the complexity of interactions in a family, introduces stress, and provides the potential for growth and maturation

Characteristics of Culture

The art, literature, costumes, customs, language, religion, and religious rituals of a particular group of people are manifested by their culture. Thus people and their patterns of life make up the culture of a particular region or country, and cultures vary throughout the world. Such differences extend across geographic boundaries, and this diversity in cultures results in the diversity of people everywhere.

A community health care nurse is conducting a survey about homeless children in the community. Which finding helps the nurse distinguish absolute homelessness from relative homelessness?

The children do not have a physical shelter and may sleep outdoors or in vehicles.

Urinary retention is not unusual in _________, and can lead to frequent infections and impaired renal function. Young adults The elderly Middle agers Older adults

The elderly

Socialization

The family has been viewed traditionally as the primary unit of socialization, the basic structural unit within a community. · Socialization is the process of being reared and nurtured within a culture and acquiring its characteristics · This process can and does occur on many different levels: within families, communities, schools, and spiritual or religious groups. Socialization usually occurs within the structure of a group that influences the health care behaviors and beliefs of its members and can directly and indirectly affect the administration of health care by the nurse

How can health care despairities be minimized by nurses?

The first step for nurses is to not let their prejudices affect the care that is provided to each patient equally. In addition, nurses can practice cultural competence,which is demonstrating intentional effort to learn about other cultures and providing indifferential care, a process that begins with a personal cultural self-assessment.

Biculturalism

The individual has a dual pattern of identification and chooses which aspects of the new culture he or she wishes to adopt and which aspects of the individual's original culture he or she wishes to retain.

RESPECT model concerns and fears

The loss of power and control that a patient faces can contribute to_____________________ about treatment, illness outcomes, and the future.

Perception

The process by which we receive, organize, and interpret sensation. Sensory perception can then be defined as the ability to receive sensory input and translate into meaningful information

Define development

The sequence of physical, psychosocial, and cognitive developmental changes that take place over human lifespan, includes growth, maturation, and differentiation.

Define equilibrium

The state of balance (acoustic nerve)

The nurse is educating parents about the changes to expect when their child enters toddlerhood. Which information would the nurse include?

The toddler has protruded abdomen

Culturally congruent care

The use of culturally based knowledge in sensitivity, creative, safe, and meaningful ways to promote the health and well being of individuals or groups.

What are the most vulnerable populations

The very old and the very young

What is the focus of an adolescent?

Their Peers "their friends" not Mom and Dad

Respect T

Theraputic

Which concept would the nurse consider when caring for school-aged children who are obese?

There are familial influences on childhood eating habits

How do these cultural norms influence nursing and health care delivery?

These cultural norms influence nursing and healthcare delivery because you have your own set of thoughts about how something is done or should be done or handled. Like in some cultures women don't make their own decisions about their health. In these cultures, the man in the family would make these decisions and we as nurses have to be able to recognize that and know that even though that is not how decisions are made for us it is that way for this culture. Another way these cultural norms would influence nursing is knowing the patients beliefs, like in terms of jehovah's witnesses who don't accept blood transfusions.

How are healy care despairities linked to the concept of culture?

This can be tied to the concept of culture in that culture can sometimes be the reason that healthcare is lacking. Care providers are sometimes influenced by generalizations, stereotypes, and personal experiences that may cause them to provide minimal care to a patient of a different culture, leading to a disparity in the health care that the patient is getting compared to the patient in the next room with which the provider may have a shared culture.

How do toddlers learn self-protection?

Through trial-and-error strategies

Which risky adolescent behavior has increased in occurrence in recent years?

Using electronic vapor products

Which surgeries are associated with permanent contraception?

Vasectomy and tubal litigation

If a patient's primary language differs from that of the health care professionals providing care, which action is most appropriate for the nurse to take?

Verify patient understanding of questions asked when the patient responds with continuous affirmative answers.

During middle age, ____________ continues to decline, with the middle ager becoming hyperopic and presbyopic. Low vision Hearing Visual dexterity Visual acuity

Visual acuity

Describe the physical assessment the rn would include when assessing cognition

Vitals and head to toe to determine extent of cognitive alterations. Monitors vitals on regular basis and notes changes or abnormalities. Hypertension is a leading Cause of stroke. Orthostatic hypotension can cause confusion, disorientation if patient changes positions too quickly. Confusion and disorientation may be effects of high fever. Hypoxia leads to dizziness and changes in level of consciousness

When individuals reach 80 years, their bodies are starting to __________. Regenerate Stagnate Stabilize Wear out

Wear out

Receptive aphasia

Wernicke aphasia / can not comprehend written or spoken language. Auditory pathway is intact but words don't make sense (usually occurs after cva or traumatic brain injury)

List the questions associated with the RESPECT model.

What do you call the problem? What do you think has caused the problem? Why do you think it started when it did? What do you think the sickness does? How does it work? How severe is the sickness? Will it have a long or short course? What kind of treatment do you think you should receive? What are the chief problems the sickness has caused? What do you fear most about the sickness?

Questions regarding RESPECT model

What do you call the problem? What do you think caused the problem? Why do you think this started ?When? What kind of treatment do you think you should receive? What are the chief problems the sickness caused? What do you fear most about the sickness?

Industry versus Inferiority

When children enter school, their social realm expands. Children in this stage take great pride in accomplishments. Peers and teachers take on more importance, while parental influence decreases. Failure, whether incurred in a real sense or through an inability to meet one's own expectations, can lead to a sense of inadequacy or inferiority. It is the responsibility of parents and other adult role models to help children understand what constitutes success and failure.

What tests or labs should nurse monitor for in an individual with alteration in sensory perception

With elderly patients nurse should ask questions related to all of the senses specifically. Nurse should monitor electrolytes such as sodium, potassium, chloride, calcium, and magnesium. Hypocalcemia cab contribute to diminished tactile response. Diabetic pt should be monitored for diabetic retinopathy and peripheral neuropathy. MMSE would be valuable in monitoring for sensory alteration. Vision and hearing screenings are key to identify auditory and visual impairments.

During ______________, men and women will make career and personal decisions that will affect the rest of their lives. Middle age Older adulthood Young adulthood None of the above

Young adulthood

infant

birth through 12 months

Teach women that helps reduce SIDS risk.

breastfeeding

expanding family

by the birth or adoption of a child or by blending families with children through marriage or cohabitation

Family dynamics are negative when

caregivers don't agree or lack of care or caregiver, family members don't know role, 1st time parents unsure of new situation, stress, social isolation, inaccurate perceptions, faulty personal interpretations. Places extra stress in families. This affects nursing care by not being able to give adequate care, family centered care is difficult, nurse will provide sxtra support, need t provide extra resources

Developmental arrest

cessation of 1 or more phases of development before it reaches completion

Developmental delay

cessation of 1 or more phases of development before it reaches completion

A cultural assessment

helps nurses gain an understanding of the meaning of the illness to the patient, expectations the patient has regarding treatment and care, and the patient's perception about the process.

Advise parents not to use .

home cardio-respiratory monitors These monitors haven't been found effective in reducing SIDS risk. If parents ask your advice on buying an apnea monitor, inform them that although these monitors have value for some infants, no evidence supports the claim that they decrease SIDS incidence

Developmental-

how relationships are developed, risks, stressors, stability, life events both positive and negative, abuse, illness.

Give examples of four aspects of cultural competence Self-awareness

identifying and understanding one's own cultural identity.

Urge parents to the infant

immunize AAP recommendations to take him or her for regular well-child checks.

Healthcare professionals, parents, and child care providers should follow SIDS risk-reduction recommendations from the time of the .

infant's birth

child abuse

intentional physical or emotional abuse or neglect, including sexual abuse, of a child, usually by an adult

Avoid the infant.

overheating advise parents to dress the infant in one layer more than what the parent is comfortable wearing. For example, a parent who dresses in shorts and a top should dress the infant in a "onesie" and add a knit or cotton sleep sack.

Give the infant a at nap time and bed time.

pacifier Studies show this provides a protective effect. For breastfeeding infants, delay pacifier initiation until breastfeeding is well-established (around age 3 to 4 weeks).

culture

passed from generation to generation and can affect relationships among family members

Emic

perspective that focuses on the local, indigenous and insiders culture.

Discrimination

policies and practices that harm a group and its members.

Don't use sleep marketed to decrease SIDS risk.

positioners, wedges, special mattresses or sleep surfaces, or other commercial devices No evidence suggests these products offer protection, reduce suffocation risk, or are safe.

Encourage pregnant patients to get regular to decrease SIDS and SUID risk.

prenatal care

Maturation

qualitative change associated with aging that enables cells to function at a higher or optimal level

Differentiation

qualitative change from simple to complex by which initially formed cells and structures becomes specialized

Growth

quantitative change in which an increase in cell number & amp; size results in overall body size or weight or any of its parts

RESPECT model Power

refers to the importance of acknowledging that the patient is in a vulnerable position and that there is a difference between patients and health care providers in terms of access to resources, knowledge level, and control over outcomes.

The nurse can expect some____________ to earlier behaviors in a child who is hospitalized. Especially toddlers.

regression Toddlers in the hospital often find the experience upsetting, in part because it disrupts the comfort of their routine and separates them from their caregivers. Often, toddlers will react with temper tantrums to even minor procedures or routine hygienic care.

Media and product manufacturers should follow safe sleep guidelines in their messaging and marketing materials. All media outlets and manufacturers should promote a safe infant sleep environment. Through a cooperative effort, can be modeled not just in the hospital and healthcare environment but also in print, television, and media messages.

safe sleep for infants

Keep out of the crib.

soft objects and loose items These include bumper pads, wedges, sleep positioners, blankets, and pillows. Even a sleep positioner designed to reduce SIDS is unsafe. Avoid putting anything in the crib except a mattress, fitted sheet, and the infant. To provide warmth, blanket sleepers and sleep sacks are permitted.

Developmental milestones

stages of development determined by general age range

Developmental arrest

the cessation of one or more phases of development before it reaches normal completion

developmental age

the chronological age at which most children show a particular level of physical or mental development

Middle Age Cognitive Characteristics

•may be decreases short-term memory or recall. •the speed at which information is processed and new material is synthesized also diminishes.

Negative family Dynamics Quality of Relationships

-become negative and dysfunctional as a result of social isolation -perceptions that are inaccurate -faulty personal interpretations of information *Observing dysfunctional interactions and communications of parents can lead children to imitate those negative behaviors.

Four Months

-good head control -rolls from side to side -takes object, such as a rattle, held near hand -may begin reaching -follows moving object when held in sitting position -laughs aloud -enjoys play

One year

-pulls self to standing-may step with support -picks things up with thumb and one finger -stacks two blocks -gives toys on request -gives affection -follows simple directions accompanied by gestures -may say 2 or 3 words

One month

-raises head slightly off floor or bed, when laying on the stomach -holds head up briefly when supported -briefly watches and follows object with eyes -avoids mildly annoying sensations (placement of cloth on face) -some "noise in throat sounds"

Nine Months

-sits alone-changes position without falling -plays with 2 objects at the same time -says ma-ma ba-ba

Six Months

-sits with minimal support -rolls from back to stomach -transfers objects from hand to hand and from hand to mouth -babbles-more than two sounds

describe the different types of family

-the nuclear family, -married-parent families, -extended families, -married-blended families, -cohabiting-parent families, -single-parent families, -no-parent families, -same-sex families.

Five years

-walks backward heel to toe -runs on tiptoe -prints a few capital letters -recognizes own printed name -cuts food with knife -plays with others -answers verbally to "Hi" and "How are You?" -laces shoes

Three years

-walks upstairs -stands briefly on one foot -ride tricycle -feeds self -opens doors -verbalizes toilet needs

Eighteen Months

-walks-may run a bit -climbs up and down one step -likes pull toys -likes being read to -makes marks with crayon on paper or table -partially feeds self -may say 5-10 words

Three Months

-lifts head and chest when lying on stomach -vigorous body movement -head control is improving -recognizes bottle or breast -coos -chuckles

Culturally competent care would encourage which action by a patient's family?

Asking the family's spiritual advisor to visit the patient

Infrastructure

Infrastructure provides the basic necessities of life. It is one of the three (social structure and superstructure are the other two) structural elements that works together to keep culture strong.

Peripheral neuropathy

Nerve damage away from center of the body

development

affects the number and type of interactions within a family and influences the complexity of those interactions

family dynamics

interrelationships between and among individual family members or "the forces at work within a family that produce particular behaviors or symptoms

Pre-School Health Assessment Questions (pag 248 yoost )

• Has your child had frequent infections or colds? • Is your preschooler toilet-trained? • What types of activities does your preschooler enjoy? Can your preschooler ride a tricycle? skip? hop on one foot? • Does your preschooler play with other children? • What is your child's typical diet during the day? • Does your child talk in sentences? • Can your child write his or her own name? • Does your preschooler play make-believe?

Adolescent Cognitive Characteristics

•are able to apply abstract thought processes, •logic, introspection, and a mature level of reasoning to solve problems. •Teens are able to make decisions based on the context of the situation, with consideration of all possible outcomes, this does not mean teens will always make good decisions Teens commonly are exposed to drugs, tobacco, alcohol, and situational influences on sexual behavior. •Toward the end of this stage, teens begin to think of their future in terms of higher education and careers.

Middle Age Psychosocial Characteristics

•stage of great adjustment •At the beginning of this phase, individuals are future oriented, working their way up the career ladder until they reach retirement age. •also a time for mid-life crisis,which may be exacerbated by the empty nest syndrome. •will want to broaden their interests and give back to their communities by joining charities, organizations, political groups, or other causes. •adjust to their new reality and look forward to retirement and changes in life-style, where they can travel, enjoy hobbies, and re-establish themselves as a couple and even grandparents. •may feel stymied at work, stuck in a rut, or feel old. In addition, many middle-angers will recognize their limitations and measure their one-time goals against their actual achievements. •a time when long-term relationships may suffer, as spouses may want to be with someone new and exciting to prove their vitality, youth, attractiveness, and feelings of self-worth. •the most common issues facing middle-age adults is feeling they are sandwiched between meeting the needs of their children and partner as well as those of their aging parents.

Two Months

-holds head erect, bobbing, when supported in sitting position -follows moving person with eyes -imitates or responds to smiling person with occasional smile -vocalizes

Give examples of four aspects of cultural competence cultural desire.

*refers to an interest and intent to understand people who are different from oneself. *is a personal choice; *provides the means for overcoming one's biases and their effect on care. *leads to patient-centered care as the nurse becomes more attuned to differences between individuals.

Health assessment questions for toddlers

- What age did your toddler start walking? Is your toddler sleeping through the night? Routine of sleep? Consistent bed times? Sleep environment? What foods they eat? If your toddler saying words? How many? Do they interact with you and others? How do you enforce boundaries? Rewards/punishments? How do you comfort tantrums?normal ambulatory? throw ball? grasp small objects? walking up and down stairs, hop on 2 feet? 1tbsp solid food per year old

Positive family Dynamics. Quality of Relationships

-Positive, healthy family dynamics are characterized by relationships that are loving and respectful. -Family members support each other, - provide nurturance and assistance, -form a unit within society.

One year

-Pulls self to standing, may step with support. -Picks things up with thumb and one finger. -Stacks two blocks. -Gives toy on request. -Give affection. -Follows simple directions accompanied by gestures. -May say 2-3 words.

One Month

-Raises head slightly off floor or bed, when lying on stomach. -Holds head up briefly when supported. -Briefly watches and follows objects with eyes. -Avoids mildly annoying sensations (placement of towel on face.) -Some noise in throat sounds.

Six Months

-Sits with minimal support. -Rolls from back to stomach. -Transfers objects from hand and from hand to mouth. -Babbles-more than two sounds.

Five Years

-Walks backward heel-toe. -Runs on tiptoes. -Prints a few capital letters. -Recognizes own printed name. -Cuts food with knife. -Plays with others. -Answers verbally to "Hi, how are you?" -Laces shoes.

Three Years

-Walks upstairs. -Stands briefly on one foot. -Rides tricycle. -Feeds self. -Opens door. -Verbalizes toilet needs.

Eighteen Months

-Walks- may run a bit. -Climbs up or down one step. -Likes being read to. -Makes marks with crayon on paper or table. -Partially feeds self. -May say 5-10 words.

Four years

-hops in place -throws ball over head, catches ball bounced to him -copies circle -points to 6 basic colors -knows own sex, age, last name -begins to play with other children -uses sentences -washes hands

When preparing to administer medications safely to a pediatric client, the nurse would recognize which as the minimum age that pharmacokinetic parameters in pediatric clients become similar to those in an adult?

1 year

In the healthcare setting, teens should be told that anything said to the staff will be kept in confidence, except if they say they are going to ___________. Harm themselves or others Use profanity Criticize their parents Lie about their sexual activities

Harm themselves or others

Toddlers- Cognitive Characteristics

18 months, the young toddler's •understand about 50 words and say about 6. •Know the names of people close to them. •Imitation of adults behaviors. For example, they scribble on paper trying to emulate an adult writing or push a stroller. •like to listen to songs or watch videos with repetition. •can follow simple one-step instructions like, "Come sit on my lap." • likes independence Age 3 •Can identify their body parts, •Understand simple directions and adult requests • Group similar objects together, •Vocabulary increases can converse in two to three sentences •tie words to actions •imitating adult speech patterns •able to verbalize their needs or demands •the onset of memory begins

About ___________ of what the preschooler says is easily understood. 50 percent 75 percent 90 percent 95 percent

75 percent

middle-old

75-85 years

Which range of heart rate is acceptable for a preschooler?

80-110 bpm

Pubescent changes may begin to appear by age ____, or even earlier in some girls. 12 10 9 8

9

The nurse performs a gross motor skills assessment on an infant. Which age should the infant obtain the ability to crawl?

9 months

Which action by a 3-month-old infant would the nurse interpret as an example of Piaget's sensorimotor stage of primary circular reaction? a. Deliberately placing the thumb into the mouth b. Accidentally kicking a ball c. Searching for an object under a blanket d. Shaking a rattle

Answer: a The deliberate action of placing the thumb in the mouth elicits a pleasurable effect. Accidentally kicking a ball is not a deliberate action. Searching for objects and shaking a rattle occur at later stages.

Racism

An unfounded belief that race determines a person's character or ability and that one race is superior or inferior to another. Scientific evidence indicates that no one race is culturally or psychologically superior to another, and past studies that have reached other conclusions have been found to be seriously flawed in their methodology or inherently biased. Health care professionals play a vital role in counteracting racism by providing unbiased, equal access, and culturally sensitive care to people of every race and culture

From the nurse's knowledge about the emerging adult according to Arnett's theory, which behavior by a 21-year-old hospitalized male patient is most appropriate for his age group? a. Talking about college courses that he is taking while working part-time at a restaurant b. Requesting that his mom be present when his IV line is started c. Stating that he cares for his disabled father and his 2-year-old daughter d. Becoming upset that he is not giving back to his community

Answer: a According to Arnett (2006), emerging adults are shifting their choices, and many are unstable; they explore more possibilities and move gradually toward enduring choices. The young adult is often slow in transitioning due to pursuing higher education. This 21-year-old is pursuing education while working part time, which fits within Arnett's theory for this age group. A 21-year-old male would be exhibiting regression if he needed his mom with him during an intravenous (IV) start. Caring for his father and daughter would be more typical of middle adults, who are called the sandwich generation. Giving back to one's community is generativity, which is Erikson's middle adult developmental task.

what is RESPECT

The RESPECT model of cultural assessment, based on a series of eight questions developed by Kleinman, provides a blueprint to develop skills needed to become culturally competent. RESPECT is an acronym for respect, explanatory model, sociocultural context, power, empathy, concerns and fears, and therapeutic alliance/trust.

The mother of a 5-month-old infant is concerned because her child is not yet sitting on his own. What is the nurse's best response to her concerns? a. Informing the mother that this is not normal and recommending further evaluation b. Telling the mother that this is normal development for a 5-month-old c. Encouraging the mother to do sit-ups with the child to encourage muscle development d. Asking the mother if the child had any trauma at birth

Answer: b 7-month-olds will first sit with help and then sit on their own. A 5-month-old is not expected to sit alone. Although sit-ups may help muscle development, the child's neurologic system must develop enough to maintain a sitting position. Asking about birth trauma is not necessary, because the child is not exhibiting delayed development. Asking about birth trauma would cause alarm and is not related to the child's ability to sit.

While assessing a patient for domestic violence, the nurse knows that which statement is true regarding domestic violence? a. It is a health risk factor only during young adulthood. b. It occurs across socioeconomic levels and cultural boundaries. c. Young women aged 20 to 24 have the lowest incidence of rape and sexual assaults. d. Women are the only victims of domestic violence whom nurses should be concerned about.

Answer: b All socioeconomic levels are affected by domestic violence. It is a health risk for adults of all ages from young to older adulthood. Young women have the highest rate of rape and sexual assault. Women are not the only victims of domestic violence. Men also may be victims of domestic violence and sexual assaults, although they are less likely to report it or to seek care.

Which behavior by the young adult patient indicates an understanding of patient education aimed at reducing the health risks for that age group? a. Smoking only one pack of cigarettes per day b. Limiting alcohol use to an occasional drink c. Using drugs found in a roommate's drawer for anxiety d. Having a relationship with a partner who was threatening in the past

Answer: b Having an occasional drink shows control and moderation. Smoking any amount is damaging, and education for cessation is needed. Using any drugs that are not directly prescribed for the person shows a lack of understanding of the risks of drugs. Staying in a relationship that has been dangerous in the past increases the risk of intimate partner violence.

A 1-year-old child grabs an Easter egg and attempts to throw it across the room. The nurse knows that the child is exhibiting which scheme according to Piaget? a. Adaptation b. Assimilation c. Accommodation d. Equilibration

Answer: b Assimilation occurs when the child attempts to use a new object in the same fashion as for a more familiar object. Adaptation is the process of adjusting schemes to new applications. Accommodation occurs when the child understands that the object is different from a more familiar object and cannot be used in the same way. Equilibration occurs when a balance is achieved between the old understanding and the new.

The nurse is performing a health assessment on a 15-year-old female patient. Which is the best way to obtain accurate information regarding her sexual activity? a. Ask the mother about the girl's sexual activity. b. Privately ask the girl about her sexual activity. c. Warn the girl about the dangers of sexual activity. d. Ask the girl if she wants birth control.

Answer: b Privately asking the girl about her sexual activity in an open and nonjudgmental fashion is the best way to obtain accurate information. Asking the mother about the girl's sexual activity may be embarrassing for the teen and her mother and may not provide accurate information. Warning the girl about the dangers of sexual activity is making a judgment. It is important to provide a nonjudgmental approach with teens. The teen may have additional questions about sexuality beyond the topic of birth control, so it is important to approach the teen in a manner that encourages open discussion.

A 2-year-old child insists on having a drink of water and having a story read to him and says, "Good night, sleep tight" at bedtime every night. The nurse knows the child is exhibiting which type of behavior? a. Controlling b. Ritualism c. Obsession d. Compulsion

Answer: b Ritualism offers the toddler a sense of security and comfort. The child is not trying to control his behavior with the ritual. Obsession and compulsion are terms commonly used in patients in older age groups and describe maladaptive behaviors.

Which term indicates a mental health disorder that is frequently seen in older adults? a. Schizophrenia b. Bipolar disorder c. Depression d. Posttraumatic stress disorder (PTSD)

Answer: c Depression is one of the psychiatric illnesses appearing most frequently in the older adult population. Schizophrenia typically is seen in younger adult populations. Bipolar disorder is usually identified before age 65 years. PTSD can be seen in any age group and usually is related to previous experience of a traumatic event.

For which person seen at a physician's office appointment would patient and family education be most critical? a. A 24-year-old male patient with a cold virus and on no medications b. A 45-year-old male patient on metformin for type 2 diabetes for the past 3 years c. A 75-year-old female patient just prescribed the anticoagulant warfarin d. A 40-year-old male asthmatic patient diagnosed 10 years ago and on albuterol

Answer: c Educating the patient and family members to the side effects of anticoagulant warfarin and its potential for bleeding is a critical part of care for the 75-year-old female patient. A 25-year-old male patient is young, and his immune system has the potential to fight off a cold virus. Education about a cold versus the flu would be helpful but is not critical. A middle adult who has had diabetes and has been maintained on this medication for 3 years would have had education when he was first started on the medication. A patient who has been using asthmatic medication for the past 10 years is likely to be knowledgeable about the medication from previous use.

Which group is referred to as the sandwich generation? a. Older adults who are caretakers for their elderly parents b. Younger adults who are reexamining their life choices c. Middle adults who are caretakers for multiple generations of their family d. Younger adults who are changing employment constantly

Answer: c Middle adults who are caretakers for multiple generations of their family tend to be sandwiched in between the needs of children, grandchildren, and elderly parents, all of whom need their attention and care. This situation can lead to many health and financial problems for the middle adult. Although older adults caring for their elderly parent also may experience significant stresses, they would not be called the sandwich generation unless they also were caring for younger members of their family. Younger adults may change jobs or middle adults may reexamine choices they have made, but these factors do not reflect the concept of the sandwich generation.

What is the best activity for a hospitalized school-age child to encourage continued appropriate development? a. Watching favorite television shows for 2 hours per day b. Keeping a journal of feelings while in the hospital c. Working on a paint-by-number project that can be completed in an afternoon d. Playing a favorite video game each afternoon

Answer: c The school-age child is in Erikson's stage of industry. He needs to work on projects that build a sense of accomplishment. A painting project that can be completed in one afternoon gives a sense of accomplishment. Although the other options are activities, they do not contribute to the primary developmental task of the school-age child—developing a sense of industry.

The nurse knows that which patient is an example of the Wear-and-Tear Theory of Aging? a. A patient who is dying of cancer at age 35 b. A 55-year-old who runs half-marathons c. A patient with depression and suicidal thoughts who is 65 d. An 88-year-old with heart failure, kidney failure, and osteoarthritis

Answer: d Dr. Weisman believed that aging occurred because of overuse and abuse to body and cells, and that this takes place on the cellular and organ systems level. An 88-year-old with multiple body system failure and damage would be exhibiting signs of wear and tear. A 35-year-old patient dying of cancer would not have overuse. A 55-year-old running in half marathons is not exhibiting wear and tear, although signs of overuse may emerge later in life. A 65-year-old person with depression is not exhibiting wear and tear. Emotional stressors are only one group of factors that can lead to aging and are not a component of the Wear-and-Tear Theory of Aging.

A preschooler's mother is concerned because her child behaves in a mean fashion toward her younger brother. The mother states, "She acts like she has no sympathy for him!" What is the nurse's best response? a. "She is very young to exhibit sibling rivalry." b. "What does her brother do to her to make her act this way?" c. "Do you fight at home? She is probably imitating you." d. "Preschoolers are not capable of putting themselves in another's place."

Answer: d A characteristic of preschool thought is that it is egocentric. That is, preschoolers are not yet able to see a situation from another's point of view. Sibling rivalry commonly appears in the preschool period. The brother's behavior has no bearing on the mother's expressed concern. The child is not necessarily imitating adult behavior but is displaying appropriate developmental characteristics.

Which factor(s) is/are likely to influence the transition from adolescence to adulthood? (Select all that apply.) a. Cultural beliefs b. Societal values c. Personal beliefs and expectations d. Governmental rules e. Societal expectations

Answers: a, b, c Cultural beliefs, societal values, and personal beliefs and expectations are all factors that influence an individual's transition into adulthood. Although governmental rules may influence certain societal values and beliefs, they are not directly responsible for the transition through adulthood. Coté (2006) states that little is socially expected during this time, so routes to adult roles and responsibilities are highly diverse.

When an injury to a child is suspicious for abuse, which is/are important to document? (Select all that apply.) a. Size and location of bruising b. Distinguishing characteristics of injuries c. Height and weight of the child d. Time of last meal e. General state of health of the child

Answers: a, b, c, e The size and location of the bruising, distinguishing characteristics of injuries, height and weight of the child, and the general state of health of the child all are considerations in determining possible child abuse or neglect. The exact location and the nature of the injury are important to document. A child who has been abused over time may be small and have other health problems stemming from the abuse. The time of the last meal may be important information but usually is not related to suspected abuse.

Which step(s) can nurses and health care providers take to remove barriers to identifying and treating victims of domestic violence? (Select all that apply.) a. Call the police. b. Ask about abuse. c. Ask for proof of domestic violence. d. Screen for domestic violence with all patients. e. Disregard reported abuse in spouses.

Answers: b, d Screening for domestic violence with all patients and asking about abuse will help identify patients who may be victims. Calling the police is a step that may be taken when abuse is confirmed but is not a step in identifying victims. Taking this step will be decided on with the involvement of both health care providers and the patient. Asking for proof may cause the victim to mistrust the health care provider. Never disregard a report of abuse. Abusers often are related to or married to the victim.

Which of these cultural groups adopts a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness?

Asian indian

Which action taken by a nurse would reflect application of an appropriate generalization in a patient care setting?

Asking the dietary intern to verify with Middle Eastern patients whether or not they eat pork

The behavior of school agers is controlled by rules, expectations, and anticipation of rewards. This holds true _________________. At home and school When playing games with friends At home and school, and when playing games with friends None of the above

At home and school, and when playing games with friends

Health assessment questions related to cognition

Do you have trouble sleeping or do you sleep too much? Have you noticed difficulty with adding numbers or doing your banking? Are you able to have conversations with others either on the phone or in person? Are you able to drive to the store or do errands? Do you ever feel sad? Do you read the newspaper? Do you live with anyone and whom? What medications do you take every day?

trust versus mistrust

During this phase, the consistent caregiver plays an important role in meeting the affection and food needs of the child. If the caregiver is inconsistent or unable to meet these needs, the child becomes frustrated and develops a sense of mistrust in those around him or her. Children who do not have a consistent caregiver during this phase may have difficulty with emotional attachments at later stages in life.

The joints of adults age 65 and over may need replacement, as they are not as _______ as they once were and cartilage and connective tissue has ________. Strong; disappeared Elastic; degenerated Supportive; lengthened

Elastic; degenerated

Middle Age Health Assessment Questions

General Information • Have you experienced any recent weight loss or gain? • Have you experienced any fatigue lately? • Do you have trouble falling asleep or staying asleep? • Do you smoke? How many packs per day? • Do you exercise regularly? • Do you drink alcohol? How many drinks per week? • Do you use any recreational drugs or substances? Cardiovascular System • Have you had chest pains? • Do you have any rapid heartbeats? • Do you become short of breath with exertion? Respiratory System • Have you been experiencing any shortness of breath? • Do you snore loudly? • Do you experience coughing or wheezing? Gastrointestinal/Genitourinary System • Do you have heartburn or indigestion? • Have you had a change in your bowel habits? • Have you noticed any bloody or black, tarry stools? • Do you have pain with urination? • Do you have to get up during the night to use the bathroom? • Do you have concerns about your sexual function? Integumentary System • Have you noticed any changes to moles or any new moles? • Do you have any rashes or itching or changes to your skin? Endocrine System • Have you experienced any recent heat or cold intolerance? • Have you experienced any excessive sweating? Neurologic System • Have you experienced any of the following recently? • Headaches • Dizziness • Fainting • Falls • Memory problems Women Only • Are you experiencing hot flashes or night sweats? • Are you having irregular menstrual periods? • When was your last mammogram? • Does your spouse or partner hit, slap, or punch you? • Are you afraid to return home? • Are there firearms or guns in your home?

Generalization

Generalization is a statement, idea, or principle that has a broad application. Often applied regarding common beliefs, behaviors, and patterns shared by a particular culture--certain behaviors may be anticipated and understood by using generalizations. They typically infer or draw conclusions from many factors. They are a beginning point; one should gather more information to ascertain whether a generalized statement is appropriately applied to an individual or group. The difference in stereotype and generalization lies not in the content but in the usage of the information

Describe the concepts interrelated to culture that are presented in the text. & What is the link to the concept?

Generalization: a statement, idea, or principle that has a broad application, and is applied when traits are fairly consistent across cultures and can be identified within a particular group, while keeping the importance of individual differences in mind. Stereotypes: a set of fixed ideas, often unfavorable, about the members of a group Prejudice: process of devaluing an entire group because of an assumed behavior, value, or attribute. Discrimination: refers to policies and practices that harm a group and its members. Race: a socially constructed concept that tends to group people by common descent, heredity, or physical attributes The link that ties these concepts together is that they are a general perceived notion and/or trait that has been passed down through generations. Our idea of culture is the totality of socially transmitted behavioral patterns, beliefs, values, customs, lifeways, and art that has shaped our worldview. Although certain behaviors may be anticipated and understood by using generalizations and the differences are invariably present among individuals within cultures, a lot of these perceived notions and/or traits can be offensive especially if acted upon. Often times this leads to negative results in health.

Health risks associated with ericksons 7th stage

Generativity vs stagnation- Develop sense of self worthy child leaves home. Generativity accomplished by successfully tearing ones own children or by engaging in activities that promote creativity. If this fails one will experience stagnation. May have mid life crises, wrinkles appear, skills depend on knowledge, experience, good judgement, and social convention. smoke? Drink? exercise? Chest pain? Rapid heartbeat? Snore loudly? Sob? Rash? Itching? Heat or cold intolerance, heartburn, pain upon urinating, normal bm?

Which theory proposes that older adults experience a shift from a materialistic to cosmic view of the world?

Gerotranscendence

Define the term health care disparities.

Health care disparity is the inequality related to access, use, and quality of care

family Dynamics. Roles of Family Members

Healthy families are able to adapt and adjust to roles that may change over time. For example, as children grow and develop, crises are encountered, illnesses develop, or family members leave home. It may be difficult for family members, especially children, to understand roles, changes in roles, the way changes affect the balance of relationships within the family,

Which of the following questions are appropriate to ask during a transcultural assessment?

How do you act when you are angry? What is your role in your extended family? When communicating with friends, how close do you stand?

Which ICNP nursing diagnosis is most appropriate for a young immigrant who expresses concern for the safety of his family members who were unable to relocate with him out of a war zone?

Impaired family process

The nurse would identify which anomaly as possibly being observed when a fetus is exposed to a teratogen during the embryonic development?

Improper development of the organs

Teenagers long for _________ but also desire some ______ on their families. Money; trust Independence; reliance Friends; independence Jobs; dependence

Independence; reliance

Health risks associated with ericksons 4th stage

Industry vs inferiority- does your child socialize well? Are they sick frequently? Do they eat a good diet? can they ride a bike? Have you noticed difficulty seeing or hearing? Peers and teachers become more important, should have full bladder control, children are a danger to themselves, too much tv is bad, watch for low self esteem, bullying, increased exposure to illnesses

Which internal variable influences health beliefs and practices?

Intellectual background

Health risks associated with ericksons 6th stage

Intimacy vs isolation- Peak physically before 30, then begin to decline. Strong cognition, increased station all thinking, problem solving ms concepts. Live nontraditional lifestyles, extended education, frequent job change, and higher paying jobs. Seek physical and emotional intimacy. Health risk include smoking, drinking, substance abuse, partner violence, diabetes, hypertension's, obesity, std, mental health, and screenings.

Define cognition

Is knowing influenced by awareness and judgement, it's composed of skills that include language, calculation, memory, attention, reasoning, learning, problem solving, and decision making.

Regarding the past experiences of clients who have immigrated, which consideration would the nurse incorporate when planning care?

It is important to first assess immigrants' values and beliefs

Which statement by a new mother observing her preterm infant in the neonatal intensive care nursery indicates that she has not yet begun the bonding process?

It's such a tiny baby

cultural competence

The ability to interact with and appreciate people of different cultures and beliefs. To attain this ability is a lifelong process. It requires intentional effort to more fully understand individuals of different cultures and ethnicities.

Sensation

The ability to perceive stimulation through ones sensory organs such as nose, mouth, ears, fingers, and eyes. Stimulus can be internal or external.

In the older adult describe physiologic changes related to cognition that occur with aging

Mental health and cognition stay generally stable. If an older adult has severe changes in behavior, loss of cognitive function it's most likely symptoms of physical or mental illness such as Alzheimer's, acute delirium, or serious depression. Depression occurs more frequently in older adults. Risk factors for depression are increased days in bed, increased pain, decreased physical activity. Arthritis, diabetes, and hypertension are risk factors for depression. Delirium can be caused by polypharmacy.

What is MMSE and how is it used as a secondary prevention

Mini mental state examination is a 30 item 10 minute questionnaire used to measure cognitive impairment and progression of disease. Another simple cognitive assessment tool for memory impairment involves recall of 3 words written down and 3 shapes drawn by patient. Both are good for early detection.

Which culturally based behavior would the nurse expect to observe in an Asian client who has symptoms of anxiety and panic?

Minimal eye contact

Because neonates airways are small—the size of a pencil—they are easily obstructed by inflammation, foreign bodies, or _________. Mucus Stridor Membranes None of the above

Mucus

Which behavioral characteristic, according to temperament theory, is demonstrated by a slow-to-warm up child?

Negative readpction to new stimuli

The nurse hired to work in a metropolitan hospital provides services for a culturally diverse population. One of the nurses on the unit says it is the nurses' responsibility to discourage these people from bringing all that alternative medicine stuff to their family members. Which response by the nurse is correct?

Nontraditional approaches to health care can be beneficial."

A new mother says to the nurse, "I would like to care for my baby independently rather than depending on the baby's grandparents." From this information, which culture would the nurse infer that the new mother belongs to?

North American culture

A client does not take his or her medication regularly and is depressed. Which inference can the nurse make about the client's motivational level?

Not motivated

Which factor is the strongest predictor of illness in a childcare setting?

Number of unrelated children in a room

Which member of the interprofessional team in a palliative care setting serves as the client advocate, evaluating the physical, emotional, and spiritual needs of the client?

Nurse

Shared beliefs, values and behaviors. How are they different?

The art, literature, costumes, customs, language, religion, and religious rituals of a particular group of people are manifested by their culture. Thus people and their patterns of life make up the culture of a particular region or country, and cultures vary throughout the world. Such differences extend across geographic boundaries, and this diversity in cultures results in the diversity of people everywhere. Because culture consists of a system of beliefs held by the people of a region as well as their principles and moral values, behavioral patterns of people from a particular geographic region of the world contribute to the region's culture.

In meeting the cultural needs of a patient what are some considerations.

Origins and Family • Where born; if in other country, length of time in United States and circumstances • Decision making within family • Cultural group(s) identify with; presence of social network • Important cultural practices Communication • Language spoken at home; skill in speaking, reading, and writing in English • Preferred methods to communication with patient and/or family member (how to be addressed, to whom questions are directed, etc.) • Ways respect is shown to others • Eye contact, interpersonal space Personal Beliefs about Health, Illness • Meaning and belief about cause of illness • Perception of control over health • Practices or rituals used to improve health • Perception of severity of illness • Expectations for treatment; use of folk remedies, alternative medicine • Practices that violate beliefs (taboos) • Concerns or fears about illness or process of treatment Daily Practices • Dietary preferences and practices; forbidden foods • Beliefs about food that pertain to health and illness • Spiritual beliefs; religious practices • Special rituals

What aspect of culture is a full-time employed granddaughter of an elderly female exhibiting if she asks the social worker to place her grandmother in an extended-care facility against the wishes of her parents?

System change

Gustation

The sense of taste- requires chemoreceptors come in contact with stimulus directly

What does health care despairity mean?

This term means that, due to various reasons (age, race, religion, gender, income, physical location etc.), health care is not granted equally to all persons. Ulitimately, it is a type of discrimination, wheather intentional, or not.

According to Erikson's psychosocial stages of development, mastery of which task increases a child's ability to cope with separation or pending separation from significant others?

Trust

Health assessment questions for ericksons 1st stage

Trust vs mistrust - does baby smile? Follow objects w eyes? Turns head at noise? Talk back? Hold object? Look at hand? Squeal? does baby roll from back to side? Sit it propped? Play w hands, clothing, blankets? Reach for objects? Put toys in mouth? Laugh out loud? Hold own bottle? Make sounds? Look for dropped toys? does baby sit up supported/unsupported? Pass toys hand-hand? Focus longer on objects? Say dada or mama? Separation anxiety? Crawl or try to stand? Resist diaper change? move face? Sit unassisted? Walk w or wo support? Words used? Search for hidden objects?

During the _________ years, all deciduous teeth are replaced by adult teeth along with the eruption of additional molars. School age Teen Tween None of the above

Tween

Which hypersensitivity reaction may occur in a newborn with hemolytic disease?

Type 2

family

a group of people who are related by heredity, marriage, or living in the same household.

Developmental Delay

a noticeable lag in a particular aspect of development

Codependency

a relationship in which a person is controlled or manipulated by another who has an illness or addiction.

Enculturation

is the process whereby a culture is passed from generation to generation.

Declarative episodic memory

is when information relates to specific events

Intimacy versus Isolation

achieved a sense of identity and has set a path for where he or she is going. The main task of this phase is to develop an intimate and trusting relationship with another person. The ideal relationship should complement the individuality of each partner without stifling growth. People who fail at developing such a relationship may retreat into isolation.

Caution women to avoid use during pregnancy and after delivery.

alcohol and illicit drug

Give examples of four aspects of cultural competence Skills

are acquired over time by careful attention to the nurse-patient relationship. One element of cultural skill is communication.

RESPECT model Respect and empathy

are attitudes that demonstrate to the patient that his or her concerns are valued and he or she is understood.

Interprofessional function assessment

assessment given to meat milestones

Integrity versus Despair

begins with late adulthood, when the person looks back over his or her lifetime and resolves any final identity crisis. Accomplishments must be reconciled with failures and limitations for the person to develop a sense of integrity. The finality of death must be accepted. A person who fails to do so risks developing a sense of despair and regret over the way his or her life has turned out.

absent extended family

children move away from their family of origin or retired parents move to a retirement area, often hundreds of miles away.

sibling rivalry

competition or animosity between and among siblings

birth

conception through birth

Four aspects of cultural competence

cultural desire. Self-awareness Knowledge Skills

Infants are very ______________ on caregivers.

dependent At birth, the infant is dependent on the caregiver for everything from feeding to positioning. The hospitalized infant is at risk for developing mistrust. If parents are unable to stay and provide care for the infant in the hospital, the nurse must ensure that infant needs such as feeding, bathing, and changing are met.

Developmental age

developmental progress determined by achieving a certain ability or skill by a certain age

Developmental Milestones

developmental progress determined by achieving a certain ability or skill by a certain age

Healthcare disparities

differences in the quality of care received by minorities and non-minorities who have equal access to care—that is, when these groups have similar health insurance and the same access to a doctor—and when there are no differences between these groups in their preferences and needs for treatment.

Functionalism

language barriers, cultural needs, familial roles, individual physical capabilities and correlation to family.

How would you characterize family-

dysfunctional, supportive, blood, live together, family is whatever the patient says it is. Some families are very close and some do not speak to each other. Healthy families know their roles, are loving and respectful, and offer support. Daughters growing and assuming the role of mother or caretaker. Older siblings step up to help around the house and with younger children.

spirituality

encompasses a mental or metaphysical belief system, often including belief in a higher being and participation in organized religion.

developmental tasks

events that need to happen in order for a person to continue growing toward becoming a healthy, mature adult

Risk factors for negative family dynamics are

expanding family, illness, partner violence, addiction, death, sexual health can all affect stress tension, fighting, disagreement, dishonest, end of relationships, recovery slowed.

Give examples of four aspects of cultural competence Knowledge

exposing one's self to other cultures and being motivated to learn.

Family dynamics are positive when

families adapt to change, are involved, have good communication, and support one another. This affects nursing care because nurse has access to familial port, focus on patient safety, and get a clearer picture f impact of illness.

Attributes -

family involves, people the family have relational obligations, verbal and nonverbal communication, interactions among family members must be flexible and changeable

functional ability

family members affects the self-concept of the family members lacking that ability, and it places stress on the members of the family who are expected to provide assistance.

Use a to decrease the risks of SIDS and suffocation.

firm sleep surface Use a crib, bassinet, or portable sleep environment that meets the safety standards of the U.S. Consumer Product Safety Commission and ASTM International (an organization that develops and delivers voluntary consensus standards). Make sure fitted sheets fit snugly on the mattress and the mattress fits snugly in the crib. Don't let an infant sleep in a car seat or a swing

transcultural nursing

focuses on human caring-associated differences and similarities among the beliefs, values, and patterned life ways of cultures to provide culturally congruent, meaningful, and beneficial health care. It is both a specialty and a general practice area that focuses on worldwide cultures and comparative cultural caring, health, and nursing phenomena.

What concepts are interrelated with family dynamics -

function ability, stress,reproduction,spirituality, culture, development

The national campaign to reduce SIDS risk should be expanded to focus on the —not just on sleep position. Family physicians and other primary care clinicians are encouraged to participate.

infant's entire sleep environment

Family dynamics are

interrelationships between and among individual family members or the forces at work within a family that produce particular behavior or symptoms.

bias

is an inclination or tendency to favoritism or partiality. Bias may be related to a preconceived notion or prejudice. For example, a nurse may consistently postpone care of elderly patients on the assumption that their care will take more time than caring for younger patients, without considering the actual acuity of the individual patients.

A family is a group of people who are related by heredity, marriage, or ______________________________

living in the same household.

Family configurations include

nuclear family, single parent families, blended families, widowed families, family related by blood and also not related by blood.

Developmental arrest

ongoing lag in meeting developmental milestones at expected times

Developmental delay

ongoing lag in meeting developmental milestones at expected times

RESPECT model explanatory model,

or understanding of what is the cause of his or her illness,

old-old

over 85 years

Development

sequence of physical, psychosocial, and cognitive developmental changes that take place over the human lifespan

Caution parents not to , but encourage them to share a room with the infant.

share a bed with their infant while sleeping with their infant while sleeping Bed sharing isn't recommended with siblings, either (even with the infant's twin). If a breastfeeding mother chooses to bring her infant to bed for feeding, she should return the infant to the crib (or bassinet or portable crib) once feeding is complete, be- fore she goes to sleep. Any other person in the bed with the infant increases the SIDS risk. On the other hand, studies show SIDS risk decreases by nearly half when the infant shares a room (not a bed) with parents.

Instruct women to avoid during pregnancy and after delivery.

smoke exposure

Autonomy versus Shame and Doubt

the child has begun to walk and to speak in basic terms. Children in this stage strive to do things for themselves. The conflict lies in children's dual desires to hold on and to let go. The parents' role at this stage is best served by providing flexible but firm guidance, thereby allowing autonomy while providing safety and security. The child is given choices within reasonable boundaries. With parents who are overly controlling and restrictive, children may develop a sense of shame and doubt in their own abilities.

Culture

the enduring behaviors, ideas, attitudes, values, and traditions shared by a group of people and transmitted from one generation to the next

"dynamic"

the interactions between family members are fluid and change with growth and development, time, and circumstances

variety of family configurations

the nuclear family, married-parent families, extended families, married-blended families, cohabiting-parent families, single-parent families, no-parent families, and same-sex families.

Cultural sensitivity

the recognition that there are differences among cultures.

Identity versus Role Confusion

the teen attempts to determine a sense of who he or she is. This stage is experienced as a time of great change. Not only is the body undergoing major physical changes, but pressures are emerging for the young person to make decisions about future education and career choices. Teens typically experiment with different sexual, occupational, and educational roles while they try to develop a sense of identity as they approach adulthood. When adolescents fail to figure out their sexual, occupational, or educational path, conflict results.

Encourage supervised " " while the infant is awake and alert, to promote optimal growth and development.

tummy time Recommended duration and frequency haven't been established. However, in my practice environment, the standard of care is to give the infant tummy time (when supervised and awake) with every diaper change for 5 to 10 minutes during the day. Tummy time promotes motor development and helps prevent positional plagiocephaly (head flattening).

what does the nurse do to communicate for a patient that does not speak English and consent needs to be signed. the patient's family is at the bedside and are ready and eager to help.

use of interpreters. ask the patient their preferred way to communicate. Consent in the patients own language use of MARTI

RESPECT model sociocultural context,

which comprises factors in a person's life that may contribute to the current state of health and expectations for treatment, such as poverty, stress, and social support.

Structural-

who lives in the home? Quality of relationship? Familial roles?

positive family dynamics

• Assistance with child care after birth of new infant • Respite care for a caregiver • Support after injury or death of a spouse • Presence during surgery • Family reunions • Celebrations of birthdays and other significant events • Praying together • Supportive in-laws • Sharing care of a dependent family member

Toddlers- Health Assessment Questions (pag 246 yoost )

• At what age did your toddler start walking? • Is your toddler sleeping through the night? • What kinds of foods does your toddler eat? • Is your toddler saying words? • Does your toddler interact with you and others?

negative/dysfunctional family dynamincs

• Child abuse • Codependency (related to substance abuse by a family member) • Interfering in-laws • Intimate partner violence • Marital infidelity • Placing blame for birth of a preterm infant or for death of a young child by SIDS • Sibling rivalry • Adolescent pregnancy SIDS, sudden infant death syndrome.

School Age Health Assessment Questions (pag 250yoost )

• Does your child get along with classmates? • What are your child's favorite activities? • Can your child ride a two-wheeled bike? play ball? • Does your child eat a well-balanced diet? • Is your child sick frequently? • Does your child have any problems seeing the blackboard at school or seeing words in a book?

Pre-School Cognitive Characteristics

•75% of what the preschooler says is easily understood. •have vivid imaginations and magical thinking •able to classify objects •enjoy arts and crafts and completing puzzles. •very inquisitive and frequently ask, Why? •use complex sentences •correctly utilize future and past tense verbs •can even read a few select words. •They can count to at least 10 and understand the concepts of numbers and amounts. •should have also memorized their phone numbers and addresses.

Pre-School Physical Characteristics

•Biologic growth slows •average weight gain is approximately 5 pounds per year •height 2 1/2 to 3 inches per year •becoming taller and thinner •more graceful and agile •can walk but also run, jump, and climb •By 4 to 5 years, the child can skip, hop on one foot, and turn somersaults •toilet trained •Fine motor skill development •ability in drawing and printing letters ex/ draw a person with six major body parts, copy shapes, and print some letters and numbers, as well as his first name. •can use scissors. •feed self •able to dress without assistance.

School Age Psychosocial Characteristics

•Bullying can lead to mental health problems including depression, low self-esteem, and suicide •may continue to have strong food preferences. •may continue to have strong food preferences. however, are more open to exploring a variety of foods. •delight in developing new skills •They gain confidence and a sense of satisfaction from peer interactions and from activities that they can carry through to completion. •enjoy competition and working together to accomplish goals. •capable of making judgments based on reasoning •grasp the concept of conservation. •knowledge is transferred to mathematical equations, and children become able to reverse the arrangement to solve problems •develop the ability to classify objects. •enjoy sorting and grouping objects by different characteristics •Fears are common, particularly fear of being hurt or of experiencing unknown procedures, Simple explanations before procedures are helpful in alleviating some of these fears.

Older Adult Physical Characteristics

•Hair becomes gray •facial skin and other parts of the body become wrinkled because of loss of skin elasticity and collagen content •Height declines as the spine collapses with bone loss and decreased muscle tone. •Reactions slow •senses become less acute •Cataracts and glaucoma may affect the eyes •hearing loss is common •Mobility declines as muscle strength declines by 30% to 50% after age 70. •Stretching exercises can reduce this decline •brain decreases in size but retains its structure and function in the absence of disease •heart pumps less blood •respiratory system is less efficient •digestive system produces smaller amounts of digestive juices, increases the likelihood of constipation •Taste and smell decrease, causing food to be less appetizing

Older Adult Cognitive Characteristics

•Older adults can continue to be active thinkers and impart wisdom to younger generations. But there can be a decline in memory, with them being able to recall things from their distant past rather than recent events. •Alzheimer's disease is a real threat Women are especially at risk •The cognitive ability of elders is individual. Some will remain sharp well into their 90s, but others will develop Alzheimer's disease or a form of dementia. •It is important to note that confusion is not a sign of permanent loss of mental ability, but can arise from illness such as a urinary tract infection, medications, or other factors. •During the normal aging process, mental health and cognition remain relatively stable. Severe changes in behavior and sudden loss of cognitive function usually are symptoms of a physical or mental illness, such as Alzheimer's disease or serious depression. •adults with Alzheimer's disease was one in eight people

Older Adult Psychosocial Characteristics

•There can be a change in lifestyle during this phase. Income may be reduced dramatically and loss of a spouse or partner means a return to single life. •Healthy older adults may pursue a second career, take up hobbies, or become an active volunteer after retirement. Other individuals may need to change their residence from a home to an independent living facility, or if in failing health, to a nursing home. •Elders have retired and may now live on a fixed income. Many of them still want to and can live independently, but others will need to live in some type of assisted living housing or even nursing homes if they require additional care. •Safe driving can also be an issue at this time. Many elders dread the loss of their license as it will be another step toward their dependence on others to help them perform tasks—such as shopping or going to appointments—that they were once able to do alone. •They do think about the end of their lives, and it is critical that families and staff support their wishes.

Adolescent Physical Characteristics

•This period of development is referred to as puberty •In both males and females, the final 20% to 25% of height generally is achieved during a 24- to 36-month period known as the adolescent growth spurt. •In females, this usually begins between the ages of 9 and 14 years and ends 1 to 2 years after onset of menstruation. •in males, with the onset between the ages of 10 and 16 years and the end between the ages of 18 and 20 years. •increased size of the heart and lungs. blood volume and blood components expand. able to meet the physiologic demands of exercise. development of muscle mass and definition is apparent, particularly in males. In females, changes include the following: • Breast enlargement • Increasing height and weight • Growth of pubic and axillary hair • Menarche (onset of menstruation) In males, changes include the following: • Enlargement of testicles • Growth of pubic, axillary, facial, and body hair • Rapid increase in height • Changes in larynx, causing lowering of the voice • Nocturnal emissions

School Age Physical Characteristics

•growing an average of 2 inches per year and gaining approximately 4 to 6 pounds per year. •becomes slimmer and even more graceful •Fat diminishes further, and the skeleton lengthens along with an increase in muscle tissue. •Boys and girls of this age have similar physical growth characteristics -In younger years- •Girls often are taller and heavier than boys.-In older years- •better able to fight infection -early in this period children often have an increased rate of illness because of more exposure to other children- •maintain a more stable blood glucose pattern. •Caloric needs decrease •increase in stomach capacity enables children to eat less frequently •full bowel and bladder control have been achieved •skeletal system continues to develop, with bones lengthening and ossifying •Preventive health is important during this time, as immunizations are brought up to date before starting school.

School Age Cognitive Characteristics

•longer attention span, •can handle and classify problems, •starts to think abstractly and reason •begin to view things from a perspective other than his own. •comprehends and can tell time •perfecting his reading •writing and math skills •uses language correctly •he is enjoys playing board and card games •likes school and is proud of his achievements there.likes school and is proud of his achievements there. •can express their feelings, likes, and dislikes, and discuss issues that are relevant to them. •some things talked about are unfamiliar to them, they will simply nod their heads to indicate understanding when there is none rather than admit they are lost in the conversation. •attached to their phones and text, speak, or tweet constantly as there is a huge need for peer interaction.

Young Adult Cognitive Characteristics

•most people are completing their higher education •mental ability peaks with sharp reasoning skills, creative imaginations, rapid information recall, and proficiency in communication. •can contemplate the views of another and put themselves in the other's place to gain a better understanding, thus achieving mature empathy.

Adolescent Psychosocial Characteristics

•peer-group influence peaks •need for privacy at this stage is very strong. •struggle to accept the body image changes associated with adolescence. •isolate themselves from the rest of the household in an attempt to exercise their independence and separate from their parents •Bulimia and anorexia are psychological problems that develop during adolescence leading to nutrient deficiencies and underweight.

Pre-School Psychosocial Characteristics

•remain egocentric •want to please their family and friends •increasingly independent and begin to assert themselves •play cooperatively with other children •They can share, be sensitive to others feelings, and want to emulate their friends •can also become aggressive •boast about their successes •tattle about playmates actions they find distasteful. -behavior can be modified by rewards and punishments. Child needs a clear and consistent set of boundaries. In fact, he prefers to live by rules and rituals,

Young Adult Psychosocial Characteristics

•searching for and finding their place in world, •dramatic change in personal relationships. •seek emotional and physical intimacy in relationships with peers and romantic partners. •Self-disclosure and a sense of belonging are important aspects of intimacy. •lack of personal contact may lead to a weakening of intimacy and a decline in psychological well-being. •have friends but have increasingly limited time to spend with them. •Women's friendships usually are more intimate than men's. •creating values that will provide them with self-satisfaction and a sense of contributing to society.